Department of Pulmonary Medicine, Porvoo Hospital, Porvoo, Finland.
Doctoral Programme of Clinical Research, University of Helsinki, Helsinki, Finland.
Scand J Prim Health Care. 2020 Mar;38(1):42-46. doi: 10.1080/02813432.2020.1717093. Epub 2020 Feb 4.
Tobacco smoking is a well-established risk factor for postoperative complications. Research on preoperative smoking cessation in primary health care is scarce. This was a retrospective cohort study. The (SSSP) started in Porvoo, Finland, in May of 2016, involving both primary health care and specialized health care. The goals of the project were smoking awareness and preoperative smoking cessation. Our study involved 1482 surgical patients operated at Porvoo Hospital between May and December of 2016. We studied the recording of smoking status in all patients, and ICD-10 diagnosis of nicotine dependency and the initiation of preoperative smoking cessation in current smokers. Variables were studied from electronic patient records, comparing primary health care referrals and surgical outpatient clinic records. Smoking status was visible in 14.2% of primary health care referrals, and in 18.4% of outpatient clinic records. Corresponding rates for current smokers ( = 275) were 0.0 and 8.7% for ICD-10 diagnosis of nicotine dependence, and 2.2 and 15.3% for initiation of preoperative smoking cessation. The differences between primary health care referrals and outpatient clinic records were statistically significant for all three variables ( ≤ .001). In primary health care, very little attention was paid to preoperative smoking cessation. Rates were significantly better at the surgical outpatient clinic, but still low. We could not demonstrate any certain effect of the intervention. Our results call for future research on ways to improve smoking cessation rates.Key pointsTobacco smoking is a well-established risk factor for postoperative complications. Research on preoperative smoking cessation in primary health care is scarce.We found weak smoking awareness and weak smoking cessation intervention numbers among both primary and specialized health care doctors. Our results indicate an urgent need for an efficient preoperative smoking cessation model involving both primary and specialized health care.
吸烟是术后并发症的一个既定危险因素。在初级保健中进行术前戒烟的研究很少。这是一项回顾性队列研究。该研究于 2016 年 5 月在芬兰波尔沃开始，涉及初级保健和专门保健。该项目的目标是提高对吸烟的认识和进行术前戒烟。我们的研究涉及 2016 年 5 月至 12 月期间在波尔沃医院接受手术的 1482 名外科患者。我们研究了所有患者的吸烟状况记录，以及 ICD-10 尼古丁依赖诊断和当前吸烟者术前戒烟的启动情况。通过电子患者记录研究了变量，比较了初级保健转诊和外科门诊记录。在初级保健转诊中，吸烟状况可见的比例为 14.2%，而在门诊记录中则为 18.4%。相应的当前吸烟者（ = 275）的比例为 0.0%和 ICD-10 尼古丁依赖诊断的 8.7%，以及 2.2%和术前戒烟的 15.3%。所有三个变量（ ≤ .001）的初级保健转诊和门诊记录之间的差异均具有统计学意义。在初级保健中，对术前戒烟的关注很少。在外科门诊的比例明显更好，但仍然很低。我们无法证明干预有任何确定的效果。我们的研究结果呼吁对提高戒烟率的方法进行进一步研究。
吸烟是术后并发症的一个既定危险因素。在初级保健中进行术前戒烟的研究很少。
我们发现初级和专门保健医生的吸烟意识薄弱，戒烟干预数量也很少。我们的研究结果表明，迫切需要一种有效的术前戒烟模式，涉及初级保健和专门保健。
